Provider Demographics
NPI:1538896196
Name:BONEE, TRACY (APRN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BONEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PLAINS
Mailing Address - State:AR
Mailing Address - Zip Code:72568-0084
Mailing Address - Country:US
Mailing Address - Phone:501-593-3441
Mailing Address - Fax:
Practice Address - Street 1:60 GREERS FERRY RD
Practice Address - Street 2:
Practice Address - City:DRASCO
Practice Address - State:AR
Practice Address - Zip Code:72530-9130
Practice Address - Country:US
Practice Address - Phone:870-668-3200
Practice Address - Fax:870-668-3634
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR221401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily